en ENGLISH
eISSN: 2083-8441
ISSN: 2081-237X
Pediatric Endocrinology Diabetes and Metabolism
Bieżący numer Archiwum Artykuły zaakceptowane O czasopiśmie Suplementy Rada naukowa Recenzenci Bazy indeksacyjne Prenumerata Kontakt Zasady publikacji prac
SCImago Journal & Country Rank
 
1/2022
vol. 28
 
Poleć ten artykuł:
Udostępnij:
więcej
 
 
streszczenie artykułu:
Opis przypadku

Nietypowy gruczolak przytarczyc: ciężkie objawy u dorastającej dziewczynki

Hiya Boro
1
,
Sarah Alam
1
,
Vijay Kubihal
2
,
Saurav Khatiwada
1
,
Suraj Kubihal
1
,
Shipra Agarwal
3
,
Rajesh Khadgawat
1

1.
Department of Endocrinology and Metabolism, All India Institute of Medical Sciences (AIIMS), New Delhi, India
2.
Department of Radiodiagnosis, All India Institute of Medical Sciences (AIIMS), New Delhi, India
3.
Department of Pathology, All India Institute of Medical Sciences (AIIMS), New Delhi, India
Pediatr Endocrinol Diabetes Metab 2022; 28 (1): 91–100
Data publikacji online: 2022/02/11
Pełna treść artykułu
Pobierz cytowanie
ENW
EndNote
BIB
JabRef, Mendeley
RIS
Papers, Reference Manager, RefWorks, Zotero
AMA
APA
Chicago
Harvard
MLA
Vancouver
 


Introduction
Primary hyperparathyroidism (PHPT) is a disease that is usually diagnosed in an asymptomatic state during routine biochemical screening. It generally manifests as a sporadic disease in post-menopausal women. However, in India and developing countries, we continue to see severe skeletal and renal manifestations of the disease.

Case report
Herein, we describe the case of a 16-year-old adolescent girl who presented with severe manifestations of primary hyperparathyroidism. Biochemically, she had severe parathyroid hormone (PTH)-dependent hypercalcaemia with hypophosphataemia and vitamin D deficiency (serum total Ca – 18.5 mg/dl [8.5–10.5 mg/dl], serum PO4 – 1.9 mg/dl [2.5–4.5 mg/dl], serum ALP – 2015 IU/l [80–240 IU/l], serum 25[OH]D – 19.1 ng/ml [30–100 ng/ml] and serum iPTH > 5000 pg/ml [15–65 pg/ml]). Pre-operatively, she required management with saline diuresis, bisphosphonate, and calcitonin. After surgery, the patient had severe hungry bone syndrome (serum Ca – 4.1 mg/dl, serum PO4 – 2.1 mg/dl, serum ALP > 10,000 IU/l) that required treatment with calcium infusions for almost 3 months. Although the clinical and biochemical picture was suggestive of parathyroid carcinoma, histopathology revealed atypical parathyroid adenoma with low proliferative index. Atypical parathyroid adenoma is a term applied to a neoplasm with ‘worrisome’ features but not fulfilling the ‘absolute histopathological criteria of malignancy’.

Conclusions
Atypical parathyroid adenoma, a rare cause of PHPT, may be associated with severe manifestations. Although malignancy was not discerned in the immediate post-operative period, we plan to continue long-term follow-up of the patient to look for any signs of recurrence or development of parathyroid carcinoma.


facebook linkedin twitter
© 2022 Termedia Sp. z o.o. All rights reserved.
Developed by Bentus.